Mwenibamba Rodrigue Mupenda, Nteranya Daniel Safari, Mukakala Augustin Kibonge, Wabene Christian Bisimwa, Rugendabanga Angelique Mufariji, Kibukila Fabrice, Mitima Nathan Bisimwa, Niyondiko Jean Claude
Surgery Department University Clinics of Bukavu Official University of Bukavu Bukavu Democratic Republic of the Congo.
Faculty of Medicine University of Lubumbashi Lubumbashi Democratic Republic of the Congo.
Clin Case Rep. 2022 Apr 18;10(4):e05747. doi: 10.1002/ccr3.5747. eCollection 2022 Apr.
Fournier's gangrene, a rapidly progressive necrotizing fasciitis of the perineum and external genitalia that leads to extensive soft tissue necrosis, remains a medical-surgical emergency. The authors present a case of coverage of a scrotal loss of substance with testicular exposure by a medial fasciocutaneous flap of the unilateral thigh after debridement and initial medical treatment of Fournier's gangrene in a 50-year-old quadriplegic patient. The clinical examination at 8 months showed an aesthetic and functional result. The trophic-cutaneous thigh flap that the authors propose for frail, elderly, and neurological subjects with low functional requirements allows coverage of the scrotal region with relatively thick skin, color, and texture close to those of the scrotum. It also offers technical simplicity, moderate scarring, and functional remnants at the price of less morbidity.
福尼尔坏疽是一种会导致广泛软组织坏死的、进展迅速的会阴部和外生殖器坏死性筋膜炎,仍然是一种外科急症。本文作者介绍了一例50岁四肢瘫痪患者,在对福尼尔坏疽进行清创和初步药物治疗后,采用单侧大腿内侧筋膜皮瓣覆盖阴囊组织缺失并暴露睾丸的病例。8个月后的临床检查显示外形和功能恢复良好。作者提出的针对身体虚弱、老年和功能需求较低的神经功能障碍患者的营养性大腿皮瓣,可利用相对较厚的皮肤覆盖阴囊区域,其颜色和质地与阴囊相近。该方法技术操作简单,瘢痕形成适度,功能保留良好,且发病率较低。